Neck Dissection

2.8.1 Describe the vascular supply to the skin of the neck. Why is this important in planning incisions for neck dissections? 

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2.8.2 What is the radiographic criteria for lymph node metastases?

2.8.3 Review TNM staging of the neck.

2.8.4 Discuss CT/PET scan, CT, ultrasound, MRI in detecting cervical metastases. What is the most sensitive test?

2.8.5 What are the levels of the neck as it relates to lymph node groups? What are the anatomic versus radiographic boundaries of each level?

2.8.6 Radical vs. modified radical vs. selective neck dissection….definition and indications.

2.8.7 Name and describe four selective neck dissections.

2.8.8 You suspect a chyle leak in patient status post modified radical neck dissection. How will you confirm and manage this problem? At what point do you surgically intervene? Could it have been prevented?

2.8.9 What is an N0 neck? Why is it controversial? When should you electively treat the N0 neck with either a neck dissection or radiation?

2.8.10 What is the risk of occult metastases with the different subtypes of head and neck cancer (lip, oral cavity, oropharynx, hypopharynx, larynx, subglottis, salivary gland cancers)?

2.8.11 What is the role of sentinel lymph node biopsy in the treatment of melanoma, merkel cell carcinoma, oral cavity cancer, advanced skin cancers?

2.8.12 Discuss the workup and management of the unknown primary.